MRI CT Program

MRI CT Program

The Cardiovascular MRI/CT Program is a joint effort of Mount Sinai Heart and the Mount Sinai Department of Radiology.

The program was created to provide world-class options for patients seeking MRI and CT scans of the cardiovascular system. An additional goal of the program is to foster research in these areas. The center is able to provide patients and referring physicians with high quality, highly responsive service for cardiovascular imaging needs.

Make An Appointment

To assist us with scheduling your appointment, please have the following information ready when you call:

The name and phone number of the physician who wants you to have a scan

The reason for this exam.

Your current medical insurance information.

After you have a scheduled date, a member of our staff may contact you prior to the exam to determine if there are any reasons you should not have the test, and to answer any questions you may have regarding the procedure.

About Cardiac CT Scans

What Is a Cardiac CT Scan?

A traditional CT scan utilizes a procedure that combines many x-ray images and uses a computer to create three-dimensional views of the body. A Cardiac CT Scan uses a state of the art multi-row detector CT (MDCT) scanner that obtains thousands of images of the heart and blood vessels within a single breath-hold. This technology can be used alone to assess hardening and calcification of your coronary arteries or in conjunction with intravenous contrast dye (CT Angiography or CTA) to visualize the circulation of the heart. This latter approach can also be used to visualize the great vessels of the neck, chest, abdomen and legs.

Calcium Scoring CT Scan

This test uses the technology discussed above to visualize calcium deposits in the coronary arteries. Calcium deposits can be a sign of coronary artery disease. The amount of calcium does not correlate directly with the narrowing of a single artery, but does correlate with the overall severity of plaque (atherosclerosis) in the coronary arteries. Multiple studies have now shown that the coronary calcium score can predict the future risk for suffering from a heart attack or stroke. Coronary Artery calcium screening may be performed by itself or (more usually) in conjunction with Cardiac CT Angiography. This test does not require the use of an IV contrast agent.

What to Expect

A Nurse will contact you prior to the exam to screen you for any contraindications to the exam.

On the day of the exam a nurse/technician will assist you to change into a hospital gown, and lie on the exam table. Sticky electrodes will be placed on your chest (similar to those used during an EKG) to record your heart rhythm during the test. During the scan you will feel the table move into the scanner.

You will be instructed to take a deep breath and hold it for approximately twenty (or less) seconds. It is important you remain as still as possible during the exam. The scan itself takes about ten minutes but preparation for the exam can take up to fifteen minutes so please allow yourself about an hour for the procedure from start to finish including the registration process. After the exam you may eat and drink as usual, and resume all normal activity.

Cardiac CT Angiography

This exam is a fast, accurate, non-invasive, reliable method used to visualize the coronary arteries within a single breath hold. Cardiac CT Angiography is used to evaluate the coronary arteries for blockages, abnormalities, and to assess previous coronary artery bypass grafts for patency.

What to Expect

A Nurse will contact you prior to the exam to screen you for any contraindications to the exam.

Your physician, or our Nurse Practioner will order a blood test to check your kidney function. This can be done at a lab of your choice, or at your physician's office. This test is necessary to make sure your kidney function is normally, as the IV contrast is excreted from your body by your kidneys. This blood test must be performed within 3-6 weeks of your scheduled examination. On the day of the exam, a nurse will assist you to change into a hospital gown, and lie on the exam table. Sticky electrodes will be placed on your chest (similar to those used during an EKG) to record your heart rhythm during the exam. An intravenous line will be started and you may be given medication intravenously called a beta-blocker and sublingual nitroglycerin to slow the heart rate and dilate the arteries in order to obtain the best possible images. You will then be positioned inside the scanner. You will be instructed to take a deep breath and hold it for approximately 15-20 seconds. It is important you remain as still as possible during the exam. During the scan you will feel the table move into the scanner. The simultaneous injection of intravenous contrast may induce a sensation of warmth and a metallic taste in your mouth. This is normal and will abate in one to two minutes.

The scan itself takes only a few seconds, but preparation for the exam can take up to thirty minutes so please allow yourself about an hour for the procedure from start to finish including the registration process. As soon as the exam is completed, the intravenous will be removed and you may leave. You may eat as usual and resume all normal activity. Please drink plenty of fluids (we recommend up to 2 liters) during the remainder of the day to assist your kidneys in flushing the contrast out of your system.

Exam Results

Using a sophisticated computer program the images will be reconstructed and analyzed by our specialized team of cardiologists. The results will sent to your referring physician within 48 hours. Your referring physician will discuss the results of the exam with you.

Risks of CT

A CT scan is a low risk non-invasive procedure. CT scanners use x-rays to obtain images. For your safety, radiation exposure is kept to a minimum.

CTA uses intravenous contrast; occasionally this can cause an adverse reaction such as itching, and/or rash. Antihistamines, such as benadryl can be administered for relief. RARELY a more serious reaction can occur which can cause difficulty breathing. This may be life threatening, and require medication, and treatment to reverse the symptoms. PLEASE note that our specialized team is trained in the management of these situations and will act immediately and efficiently on your behalf. In addition pre-exam screening by our staff helps minimize your risk of potential complications.

About MRI

What is MRI?

Magnetic resonance imaging (MRI) uses powerful magnetic fields that cause hydrogen nuclei within the body to vibrate or resonate, emitting radiofrequency energy. The MRI machine detects these emissions and converts them into images, making it possible to evaluate many conditions, including very early stages of disease that were previously difficult or impossible to detect. There is no radiation exposure, and these magnetic fields are not known to be harmful in any way.

Cardiovascular MRI

This highly specialized exam allows images of the heart to be captured in real time providing a clear image of a beating heart. Displaying the function, structure, and blood flow of the heart and surrounding blood vessels, these images facilitate a comprehensive evaluation of cardiac health. Cardiac MRI can identify damage from a heart attack, diagnose congenital cardiovascular defects, and evaluate diseases of the larger blood vessels. In addition, MRI can be used to perform a minimally invasive stress test. All parts of the cardiovascular system can be imaged including arteries, veins, atria, valves, and ventricles making MRI an invaluable tool in complex cases. Furthermore MRI does not expose the Patient to potentially harmful radiation unlike many other cardiac non-invasive tests and offers exquisitely clear, complete, and detailed three-dimensional images.

Exam Scheduling

Your Physician will send us a referral for the exam. We will contact you and assist you with the scheduling of the appointment. After you have a scheduled date, a member of our staff may contact you prior to the exam to screen for any contraindications to the test and answer any questions you may have regarding the procedure.

What to Expect during Exam

On the day of your exam a Nurse will assist you to change into a hospital gown, and lie on the exam table. Adhesive electrodes will be placed on your chest (similar to those used during an electrocardiogram) to record your heart rhythm. An intravenous will be obtained so that the contrast agent Gadolinium can be administered. Gadolinium has a positive effect on the local magnetic field, making certain areas appear brighter than others and highlights certain parts of the heart or blood vessels. It is given intravenously, and side effects are minimal and extremely rare. It is NOT the same material used in exams with radiation (which are based on iodine). A surface coil, which resembles a small basket, will be put on your chest and then secured in place with straps. The magnet produces loud pounding sounds while taking the pictures, so you will also wear a pair of headphones. These will protect your hearing and also allow you to listen or talk to the Technologist at all times during the exam. The Technologist will also directly monitor you through a glass window, and a small video camera. Once you are placed inside the magnet, it is very important that you stay as still as possible while images are acquired. Even slight movements can distort the images. During the exam, the technologist will give you simple breathing commands such as when to hold your breath. The exam will consist of a series of images each of which takes usually less than half a minute to acquire. Overall, including the time to take you in and out of the scanner, the average time for a Cardiac MRI is approximately 45 minutes to one hour. You will be asked to arrive at the MRI Center about 30 minutes ahead of time to allow for registration and preparation. Please realize that a Physician is monitoring your entire exam, and that each exam is tailored to the individual Patient. Adjustments may be made that can either decrease or extend the examination time.

Special Considerations

Metal Objects

Because the exam utilizes powerful magnets certain precautions must be taken concerning certain metal objects, which may be influenced by the very strong magnetic field. Pacemakers, implanted defibrillators, neurostimulators, and metal clips in the brain are absolute contraindications to MRI. Our staff will evaluate all other metal items on a case-by-case basis.

Claustrophobia

If you are claustrophobic you may have difficulty remaining in the magnet while the images are acquired. Our staff will work with you and your physician to help you with this aspect of the test. If you are scheduled to receive sedation, or think that you may need sedation, PLEASE make sure there is someone to accompany you home.

Pregnancy

If you are pregnant or think you may be pregnant please inform your Physician and our Staff.

It is also advisable not to bring any metal objects such as watches, jewelry, or credit cards to the exam, as they are not allowed in the room.

Exam Results

Using a sophisticated computer program the images will be reconstructed and analyzed by our specialized team of Cardiologists. The results will be sent to your referring Physician within 48 hours. Your referring Physician will discuss the results of the exam with you.